Transverse Ridge Expansion and the Role of Bone Grafting: A Systematic Review

This systematic review aimed to evaluate the role of bone grafting in transverse ridge expansion (TRE) by comparing clinical outcomes of procedures performed with and without grafting. An electronic search was conducted in PubMed, Embase, and the Cochrane Library. Fifteen clinical studies met the inclusion criteria, comprising randomized controlled trials (RCTs), cohort studies, and case series. The outcomes analyzed included implant survival, horizontal bone gain, marginal bone loss, and complications. The findings revealed that both grafted and non-grafted TRE techniques achieved predictable ridge widening ranging from 3.2 to 6.1 mm, with implant survival rates consistently exceeding 92%. Although grafted sites showed slightly greater horizontal gains and improved ridge stability, these differences were modest and not clinically significant. The overall methodological quality of the included studies was moderate to low, with considerable heterogeneity in surgical techniques, grafting materials, and follow-up durations. Within the limitations of the available evidence, TRE alone appears to be a reliable approach for ridges measuring ≥3 mm, whereas grafting may be indicated for narrower ridges or in cases requiring long-term volume preservation.